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Medicare Advantage plans to test value-based insurance design

By Bob Herman  |  September 01, 2015

The CMS Innovation Center unveiled a new demonstration program Tuesday that will allow Medicare Advantage insurers to encourage the use of clinically valuable services by lowering out-of-pocket costs for enrollees.

Some Advantage plans lose members

Some Advantage plans lose members

By Bob Herman  |  August 29, 2015

Medicare Advantage has been held up as a source of solid growth for health insurers. Humana's reach and expertise in the market attracted Aetna's $37 billion buyout bid. But not all Advantage plans are benefiting from the enrollment wave.

Primary-care docs reaping the most from shared-savings ACOs

Primary-care docs reaping the most from shared-savings ACOs

By Melanie Evans  |  August 29, 2015

Accountable care organizations in Medicare's Shared Savings Program get to decide for themselves how to distribute bonuses, and primary-care doctors appear to be benefiting the most, according to a review of disclosures by the participants.

Editorial: Hospital admission policy in Dismaland

Editorial: Hospital admission policy in Dismaland

By Merrill Goozner  |  August 29, 2015

Over the several years that the CMS and hospitals have been tussling over the reasons behind the steady rise in short-term observation stays, no one until now has suggested the increase represents a deliberate effort by hospitals to avoid Medicare's 30-day readmission penalties.

Amputees decry Medicare payment overhaul for artificial feet

By Associated Press  |  August 27, 2015

Famous people don't often get involved with Medicare payment policy, but a Boston Marathon bombing survivor and a former U.S. senator who lost a leg in wartime service have joined an industry campaign to block new requirements for artificial legs and feet.

Few Medicare ACOs earned bonuses in 2014

Few Medicare ACOs earned bonuses in 2014

By Melanie Evans  |  August 25, 2015

Three out of four Medicare accountable care organizations did not slow health spending enough to earn bonuses last year, a continuation of mixed results for an initiative that federal officials have targeted for rapid expansion.

Robust Medicare Advantage competition almost nonexistent

Robust Medicare Advantage competition almost nonexistent

By Bob Herman  |  August 25, 2015

Competition among Medicare Advantage plans more closely resembles local oligopolies instead of a buzzing market overflowing with options for seniors, a new study from the Commonwealth Fund shows.

Editorial: Moving beyond a sterile reform debate

Editorial: Moving beyond a sterile reform debate

By Merrill Goozner  |  August 22, 2015

The latest Kaiser Family Foundation tracking poll showed most Americans are more concerned about the rising price of drugs than repeal of the Affordable Care Act. But drug prices are not the only cost issue on peoples' minds.

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